National Practitioner Data Bank--incomplete and future cloudy

Nearly six years after the National Practitioner Data Bank was authorized by Congress in the Health Care Quality Improvement Act of 1986, and more than a year after its actual creation, the device is still only partially operational. What is more, the success of even those limited efforts is being questioned, and the timetable for future developments remains to be firmed up. Also, the costs are much higher than estimated.     

Physician executives: where they are and what they do

As hospital operations become increasingly complex, so does the institution's management and organizational structure. Physician executives with titles of medical director, vice president for medical affairs, medical administrator, chief of staff, medical staff president, etc., are playing more important roles than ever before. This article will briefly review some recent literature describing physician executive profiles. The results from a survey of ten university teaching hospitals are also presented as supplementary information regarding current staffing models. Finally, several physician executive staffing-related issues will be discussed in light of the literature and the survey results.     

Eliminating smoking from the workplace

Employers are more readily realizing that a nonsmoking policy in the workplace is a more effective way to run their businesses. They are recognizing costs such as productivity losses, increased health and life insurance costs, employer liability for diseases jointly linked to smoking and occupational exposures, absenteeism, passive smoking-induced health care costs among nonsmokers, workers' compensation, and fire losses. Concomitantly, employees are supporting policies that limit smoking to achieve a clean air environment. Former Surgeon General Koop's goal of "a smokefree society by the year 2000" is being recognized by more and more segments of society.     

Clinical program renovation management

The day-to-day management of medical practice is so heavily influenced by tactical imperatives that few physicians have the time to think strategically. Traditionally, the difference between tactics and strategy is not a major concern of most physician executives. The realm of tactics is the short run, when managers must make do with the fixed resources at hand. Strategy addresses the long run, when all resources and markets are variable. A tactical focus is understandable, maybe even acceptable, in industries where nothing challenges traditional approaches to production of an established product or service. However, medical care in the 1990s is changing so fast that a physician executive must devote an incredible amount of time and effort just to stay confused about what is going on.     

Immigrant fertility: an examination of social characteristics and assimilation

"This study compares the fertility patterns of foreign-born and native-born women in Canada and examines whether [the] same set of social characteristics accounts for differential fertility among both the groups. The study also assesses the importance of social characteristics and assimilation on immigrant fertility behavior. Two generations of currently married/cohabiting women with spouse present are analyzed using multiple regressions. The results reveal similar effects on fertility of social characteristics for foreign-born and native-born, while in the case of younger generations the effects are stronger."     

European Community legislation and intergovernmental cooperation on migration

Recent trends in migration policy in the European Community are outlined. The focus is on the need to increase cooperation between the member states and to increase the power of the Community's Court of Justice in decision-making about migration and refugee policy.     

German-Polish migration: the elusive search for a German nation-state

"This article examines past and present migrations to Germany from the perspective of nation-state formation.... Focusing on the many experiences with the Polish minority (ranging from the eighteenth century to the present), this essay suggests that Germans have never discovered an acceptable and workable approach for dealing with large non-German minorities in the German nation-state. Rather, different regimes at different times have vacillated between an exclusive approach founded on nationalist principles and practices and an inclusive one founded on liberal principles and practices.... The confusion over the two approaches produces not only a confused immigration policy, but also reflects deep-seated confusion over the definition of the new German state and identity of the newly united German nation."     

The spatial and socio-occupational mobility of the population

The author describes topics included in a study of spatial, social, and occupational mobility in Poland. These include rural migration, the effect of the family life cycle on migration, the social impact of migration, the effect of migration on spatial distribution, and migration prospects until the end of this century.     

Return migration from Australia: a case study

"The study investigates the departure from Australia of former settlers who arrived during the 1980 calendar year. The 1980 settler arrival cohort [consists] of 75,167 visaed migrants.... The study has three main aims: (i) to analyse departures from Australia of the 1980 settler arrival cohort with a view to gauging the success of Australia's immigration program in retaining settlers; (ii) to examine the retention rates of settlers with respect to characteristics...including age, sex, marital status, country of last residence, and settler eligibility category; and (iii) to consider implications of the findings." Australia's present immigration policy is discussed, previous research on return migration from Australia is summarized, and a detailed analysis of the departure data is presented. "This study found that by August 1984, 12.4 per cent of non-refugee settlers who arrived in Australia during 1980 had departed permanently but that only 0.6 per cent of the 1980 refugee cohort had done so." These figures represent a decline in immigrant departure rates since the 1960s and early 1970s. Small differences in departure rates by place of birth, age, and marital status, which may have demographic consequences if sustained over time, are noted. (SUMMARY IN FRE AND SPA)